Kornimate/medical-research-clean huggingface dataset:
prevention of renal failure by nitric oxide in prolonged cardiopulmonary bypass.

Conditions: Heart Valve Diseases; Heart; Complications, Valve, Prosthesis; Cardiac Valve Replacement Complication

Summary: prolonged periods of cardiopulmonary bypass (cpb) cause high levels of plasma free haemoglobin(hb) and are associated with increased morbidity. we hypothesized that repletion of nitric oxide (no) during and after the surgical procedure on cpb may protect against endothelium dysfunction and organ failure caused by plasma-hb induced no scavenging.

prolonged periods of cardiopulmonary bypass (cpb) cause high levels of plasma free haemoglobin(hb) and are associated with increased morbidity. we hypothesized that repletion of nitric oxide (no) during and after the surgical procedure on cpb may protect against endothelium dysfunction and organ failure caused by plasma-hb induced no scavenging. there are three possible beneficial mechanisms of delivering no: 1. nitric oxide reduces ischemia-reperfusion injury (such as in acute myocardial infarction, stroke, and acute tubular necrosis). 2. nitric oxide has anti-inflammatory properties. as antioxidants, exogenous no may reduce injury by counteracting the cytotoxic effects of reactive oxygen species, modulating leukocyte recruitment, edema formation and tissue disruption. 3. exogenous nitric oxide prevents noxious effects of hemolysis-associated no dysregulation. during hemolysis, nitric oxide gas oxidized of plasma oxyhemoglobin to methemoglobin, thereby inhibiting endogenous endothelium no scavenging by cell-free hb. no depletion during hemolysis and its sequelae. the release of plasma free hb (with fe2+ iron) by hemolysis avidly scavenges nitric oxide (no) by the dioxygenation reaction. elevated plasma ferrous hb levels can induce a "no deficiency" state. reduced vascular nitric oxide levels can contribute to vasoconstriction, inflammation, and thrombosis, potentially contributing to systemic endothelial dysfunction after cardiac surgery with cpb.

Eligibility criteria:
inclusion criteria: * provide written informed consent * are \> 18 years of age * elective cardiac or aortic surgery with cpb, when the surgeon plans double valve replacement. * stable pre-operative renal function, without dialysis. exclusion criteria: * emergent cardiac surgery * life expectancy \< 1 year * hemodynamic instability as defined by a systolic blood pressure \<90 mmhg * administration of ≥1 packed red blood cell transfusion in the week before surgery * x-ray contrast infusion less than 1 week before surgery * anticipate administration of nephrotoxic agents, such as hydroxyethyl starch * evidence of intravascular or extravascular hemolysis
small sample，unicentric，randomized, controlled clinical study of coenzyme i for injection in the treatment of sudden sensorineural hearing loss

Conditions: Sudden Sensorineural Hearing Loss

Summary: sudden sensorineural hearing loss is one of the most common emergencies in otorhinolaryngology, and its incidence is increasing year by year and tends to be younger. at present, the pathogenesis of sudden deafness is not clear and the individual treatment effects vary significantly. in order to break through this specific treatment bottleneck, this project pioneered the clinical application of the co-regulator nicotinamide adenine dinucleotide (nad+) in the treatment of sudden deafness. therefore, this project intends to use pure tone audiometry, speech audiometry, tinnitus disability scale thi, tinnitus subjective visual analog score method vas, ear fullness subjective visual analog score method vas for data analysis, and explore the safety of coenzyme i for injection on sudden deafness and efficacy assessment.

the recruited participants were patients with sudden hearing deafness, and the basic demographic data, including name, gender, age, medical history, etc., were collected. according to the inclusion and exclusion criteria, the patients were randomly divided into the experimental group and the control group. the experimental group was given conventional treatment + coenzyme i for injection, and the control group was given conventional treatment for 14 days. baseline data were collected before treatment, and post-treatment data were collected on 3d, 7d, 14d，1m and 3m of treatment. baseline data and post-treatment data included pure tone audiometry, speech audiometry, tinnitus thi scale, tinnitus vas scale, tinnitus stupid vas scale.

Eligibility criteria:
inclusion criteria: 1. age ≥18yrs.the 2019 american sudden deafness guidelines are for patients with sudden deafness over 18 years of age; 2. patients diagnosed with sudden deafness, i.e. unexplained sensorineural hearing loss occurring within 72 hours, with hearing threshold ≥30 in at least 3 consecutive frequencies, refer to the 2019 american sudden deafness guidelines; 3. unilateral sudden deafness; 4. within 1 week of the onset of sudden deafness, no treatment in another hospital/our hospital; 5. no major neurological disease, serious systemic disease, family genetic history, major mental illness; 6. informed and agreed to join the experiment, no plan to move out or go out within 1 month. exclusion criteria: 1. other diseases such as acoustic neuroma diagnosed by imaging; 2. those who cannot tolerate nad+; 3. pregnant； 4. any other circumstances that the investigator believes should be excluded from this study； 5. do not agree to join the experiment, plan to move out or go out within 1 month.

Keywords: sudden sensorineural hearing loss coenzyme i
breestim for motor recovery in chronic stroke with moderate impairment after a long-term use (pilot).

Conditions: Motor Recovery

Summary: the overall goal is to investigate the effectiveness of a novel intervention - breathing-controlled electrical stimulation (breestim) on finger flexor spasticity reduction and hand function improvement in chronic stroke with moderate impairment after a long-term use.


Eligibility criteria:
inclusion criteria: * has post stroke ≥ 6 months , medically stable; * unilateral, single stroke (no restriction on type (ischemic or hemorrhagic) or volume (large or small) of stroke); * mas score ≥ 1, i.e., detectable finger flexor hypertonia; exclusion criteria include: * patients with visual deficit/neglect; hearing or cognitive impairment; * patients with history of pulmonary disease (asthma, chronic obstruction pulmonary disease, copd); * patients that are currently adjusting tone alternating medications (e.g., baclofen), or * patients received botulinum toxin injection to the arm/fingers \<4 months, or phenol injections \< 2 years; * patients with a pacemaker; * women who are pregnant.

Keywords: finger flexor spasticity motor recovery breestim
accuracy of pre-existing risk scoring models for predicting acute kidney injury in patients who underwent aortic surgery using a gray zone approach

Conditions: Aortic Surgery; Postoperative Acute Kidney Injury

Summary: acute kidney injury after cardiac surgery has been reported to increase morbidity and mortality. several risk scoring models for prediction of aortic kidney injury after cardiac surgery have been developed. however, predictive accuracy of these models is stil unclear. the aim of this study is to evaluate the accuracy of four pre-existing prediction models using a gray zone approach in patients who underwent aortic surgery in our institution.

acute kidney injury after cardiac surgery has been reported to increase morbidity and mortality. several risk scoring models for prediction of aortic kidney injury after cardiac surgery have been developed. however, predictive accuracy of these models is stil unclear. the aim of this study is to evaluate the accuracy of four pre-existing prediction models (akics, wijeysundera, mehta, and thakar model)using a gray zone approach in patients who underwent aortic surgery in our institution. based on receiver operating characteristic (roc) curve analysis, we will construct a gray zone using the cut-off values with a sensitivity of \< 90%, and a specificity of \< 90% (diagnostic tolerance of 10%).

Eligibility criteria:
inclusion criteria: * those who underwent elective or emergency aortic surgery in samsung medical center during between 2004 and 2010. exclusion criteria: * missing laboratory data * preoperative hemodialysis * death during or within 48 hours after surgery

Keywords: aortic surgery acute kidney injury gray zone approach
usefulness of c-reactive protein testing in acute cough

Conditions: Respiratory Tract Infections

Summary: the aim of this study is to evaluate the usefulness in russian general practice of c-reactive protein testing in patients with acute cough or lower respiratory tract infections. in addition to studying the effect of c-reactive protein testing on the prescription of antibiotics, the purpose is to find out whether the frequency of referral to radiography could be reduced.

eighteen general practitioners, from both urban and rural offices, were randomised into intervention and control groups. all registrations were made by general practitioners in their offices. the case report form was similar to that used in the grace study (genomics to combat resistance against antibiotics in community-acquired lower respiratory tract infections in europe (www.grace-lrti.org) describing symptoms, findings, and treatment in lower respiratory tract infections. * the clinical examination included a chest examination and the axillary temperature. * after the clinical examination, the general practitioners recorded their provisional diagnosis. * chest radiography was accessible for all patients. the c-reactive protein test was performed in the intervention group at both the first and second consultations. the afinion test system was used, which provides results within 5 minutes and before treatment was determined. this test is based on solid-phase sandwich immunometric analysis. general practitioners could prescribe any treatment, including antibiotics and other drugs for the cough and additional medication if deemed necessary.

Eligibility criteria:
inclusion criteria: * patients with lower respiratory tract infections/acute cough (including acute bronchitis, pneumonia, and infectious exacerbations of chronic obstructive pulmonary disease or asthma), * age 18 years or older, * an illness of less than 28 days duration, * first consultation for the illness episode, * being seen in a physician's office, * written consent to participate. exclusion criteria: * an inability to fill out study documentation, * being previously included in the study, * immunocompromised status (hiv patients, immunosuppressive treatment), * ongoing treatment with oral corticosteroids

Keywords: antibiotics primary care radiology/radiography respiratory tract infections
study to evaluate lumacaftor and ivacaftor combination therapy in subjects 12 years and older with advanced lung disease

Conditions: Cystic Fibrosis; Advanced Lung Disease

Summary: the purpose of this study is to evaluate the safety and tolerability of lum/iva combination therapy in subjects 12 years and older with cf and advanced lung disease and who are homozygous for the f508del cftr mutation


Eligibility criteria:
inclusion criteria: * homozygous for the f508del-cftr mutation; historical genotype must be documented in the participant's source documents. * percent predicted fev1 \<40 of adjusted for age, sex, and height at screening exclusion criteria: * participant currently receiving invasive mechanical ventilation. * history of any comorbidity that, in the opinion of the investigator, might confound the results of the study or pose an additional risk in administering study drug to the participant * any clinically significant laboratory abnormalities at screening that would interfere with the study assessments or pose an undue risk for the subject * a 12-lead electrocardiograms (ecg) demonstrating qtcf \>450 msec at screening * history of solid organ or hematological transplantation * history of alcohol or drug abuse in the past year * ongoing or prior participation in an investigational drug study (including studies investigating lumacaftor and/or ivacaftor) within 30 days of screening. * use of strong inhibitors, moderate inducers, or strong inducers of cyp3a * pregnant and nursing females: females of childbearing potential must have a negative pregnancy test at screening and day 1. * sexually active subjects of reproductive potential who are not willing to follow the contraception requirements * use of beta blockers or the equivalent at screening.
risk factors of gall bladder stone

Conditions: Gall Stone

Summary: gallbladder disease is a significant health burden in the developed world and its prevalence has risen by more than 20% in the past three decades in the united states, 20-25 million individuals are affected by gallbladder disease, resulting in an average annual treatment cost of $6.2 billion obesity, diet, rapid weight loss, metabolic syndrome, and conditions such as cirrhosis, crohn's disease, irritable bowel syndrome, and gallbladder stasis increase the risk of gallstone formation surgical removal of the gallbladder, cholecystectomy, is the most recommended treatment for gallbladder disease; however, the procedure increases the risk of non-alcoholic fatty liver disease, cirrhosis and metabolic effects

gallbladder disease is a significant health burden in the developed world and its prevalence has risen by more than 20% in the past three decades . in the united states, 20-25 million individuals are affected by gallbladder disease, resulting in an average annual treatment cost of $6.2 billion obesity, diet, rapid weight loss, metabolic syndrome, and conditions such as cirrhosis, crohn's disease, irritable bowel syndrome, and gallbladder stasis increase the risk of gallstone formation . surgical removal of the gallbladder, cholecystectomy, is the most recommended treatment for gallbladder disease; however, the procedure increases the risk of non-alcoholic fatty liver disease, cirrhosis and metabolic effects . oral dissolution therapy using ursodeoxycholic acid is currently one of the leading non-invasive alternative treatments for gallstones. ursodeoxycholic acid dissolves small cholesterol gallstones by decreasing hepatic secretion of cholesterol and lowering the chances of unsaturated gallbladder bile formation although oral dissolution therapy has proven to be a safe alternative to cholecystectomy, it has a gallstone recurrence rate of 50%-70% at 12 years post-treatment . the high incidence rate and treatment cost associated with gallbladder disease have encouraged the search for preventative strategies. in approximately 75% of cases, impaired gallbladder motility results from the accumulation of cholesterol gallstones. therefore, agents that reduce lipid concentrations or improve gallbladder motility may reduce the need for surgical interventions and/or the use of potentially harmful pharmaceutical products .

Eligibility criteria:
inclusion criteria: adult patients who have gall bladder stone(s) exclusion criteria: child -

Keywords: risk factors ,gallbladder stone
prehospital telemedical support in acute stroke

Conditions: Acute Stroke

Summary: the aim of the study is to investigate the quality of prehospital emergency care in acute stroke, when paramedics are supported telemedically by an ems physician.

six ambulances from five different emergency medical service (ems) districts are equipped with a portable telemedicine system. in cases of suspected acute stroke (including intracranial hemorrhage), the paramedics can use this system to contact a so called "tele-ems physician" after consent of the patient is obtained. the tele-ems physician has an audio-connection to the ems team and receives vital parameters (e.g., ecg, pulse oximetry, non-invasive blood pressure) in real-time. the transmission of still pictures (taken with a smartphone), 12-lead-ecgs and video streaming from the inside of the ambulance can also be carried out, if indicated. the tele-ems physician supports the ems team in obtaining all relevant medical history, neurological diagnosis, general diagnosis and can delegate the application of medications. this can be carried out to bridge the time to the arrival of an ems physician or in less severe cases without an ems physician on-scene. the quality of prehospital care and the possible influences on the initial inhospital phase should be investigated and compared with regular ems.

Eligibility criteria:
inclusion criteria: * suspected acute stroke * verbal consent for teleconsultation obtained or patient is not able to consent due to the severity of the emergency exclusion criteria: * no suspected stroke * patient refuses consent

Keywords: stroke teleconsultation telemedicine emergency medical service
myhealthkeeper: clinical trial study based on personal health record healthcare management

Conditions: Weight Loss; Obesity

Summary: in order to study the effectiveness of personalized healthcare intervention for lifestyle-related diseases, investigators designed this study using mobile application and clinical feedback from clinicians


Eligibility criteria:
inclusion criteria: * study participants must agree to support by him/herself at enroll time * patients without severe cardiopulmonary disease, cancer, or other acute diseases * patients must be over bmi \> 23 kg/m2 exclusion criteria: * patient who did not agree with this study * patients with severe cardiopulmonary disease, cancer, or other acute diseases * patients who were pregnant
complementary and alternative medicine use in low-income african american and caucasian adults with asthma

Conditions: Asthma

Summary: the purpose of this study is to identify the types of and frequency of use of complementary and alternative medicine (cam) strategies among low-income caucasian and african american adults with persistent asthma. the overall goal is to collect data that will increase understanding of health beliefs and behaviors in people with low-income backgrounds so that studies can be created that may help modify and improve patients' symptoms of asthma.

the rates of asthma-related deaths and disease are disproportionately high among african americans compared to caucasians. surveys indicate that middle- and upper-income caucasians use more cam than african americans, but the therapies utilized are different. this study will determine how well people with persistent asthma adhere to their treatment and whether the type and frequency of use of cam affects treatment adherence. participants will begin this study by taking part in an interview about adherence to their current inhaled corticosteroids (ics) regimen and their personal cam use. after completing the interview, participant adherence to their ics regimen will be monitored for 6 weeks. depending on the type of ics participants are taking, monitoring will be conducted either by participant self-reporting or electronic monitors that record the time and date of medication inhalation. participant adherence will also be assessed at study completion.

Eligibility criteria:
inclusion criteria: * physician-diagnosed asthma with episodes that last for long periods of time * medicaid recipients * self-identify as african american or caucasian * daily use of inhaled corticosteroids * able to speak english * have mental capacity to understand and participate in the study exclusion criteria: * prisoners * history of smoking at least ten packs of cigarettes per year * currently smoke more than one and a half packs of cigarettes per week

Keywords: complementary therapies
analgesia management in bariatric surgery

Conditions: Morbid Obesity; Bariatric Surgery Candidate; Pain; Postoperative

Summary: following laparoscopic bariatric surgery, multimodal analgesia is recommended to avoid the adverse effects of opioids by reducing their use. although lidocaine, ketamine, and dexmedetomidine have been used as adjuvant analgesics, no studies have evaluated the superiority of their intra- and postoperative infusions as components of multimodal analgesia in bariatric surgery. the present study is aimed to compare lidocaine, dexmedetomidine, and ketamine in multimodal analgesia management following sleeve gastrectomy surgery. postoperative pain scores, the requirement for additional postoperative analgesia, retching, nausea and vomiting, time to mobilization, and hospital length of stay will be evaluated.

patients will be divided into three groups. group l: the patients will receive intravenous lidocaine (2 mg/kg/h) immediately after anesthesia induction. at the end of the surgery, the dose will be decreased to 1 mg/kg/h. the infusion will continue until 12 hours after the operation. group k: the patients will receive intravenous ketamine (0.5 mg/kg/h) immediately after anesthesia induction. at the end of the surgery, the dose will be decreased to 0.3 mg/kg/h. the infusion will continue until 12 hours after the operation. group d: the patients will receive intravenous dexmedetomidine (0.5 mg/kg/h) immediately after anesthesia induction. at the end of the surgery, the dose will be decreased to 0.3 mg/kg/h. the infusion will continue until 12 hours after the operation. ketamine, lidocaine, and dexmedetomidine doses will be calculated according to ideal body weight, lean body weight, and actual body weight, respectively. randomization will be performed using a computer-generated random number list, and a statement indicating the patient's group will be placed in a closed envelope numbered according to the result. each patient will be asked to choose an envelope, and the patients will be assigned to the study according to the group mentioned in the envelope.

Eligibility criteria:
inclusion criteria: * body mass index\>35 kg/m2 * the american society of anaesthesiologists (asa) physical status class ii iii * patients who will undergo an elective laparoscopic sleeve gastrectomy (lsg) exclusion criteria: * refusal to participate * allergy to the study drugs * chronic kidney disease (creatinine\>150 μmol/l) * mental illness * liver, respiratory or oncological disease, * cardiac dysfunction (ejection fraction \<40%), * uncontrolled hypertension, * preoperative analgesic use, * chronic pain, * history of alcohol or drug addiction

Keywords: dexmedetomidine ketamine lidocaine obesity morbid pain postoperative